TOWN HALL Q&A

If you missed the Friday, April 3rd PHC All-Staff Town Hall, here’s Part One of the Q&As which includes answers to the questions which were addressed during the session. 

Didn’t get your question answered? Watch for Part Two of the Q&As coming soon which will provide answers to questions we didn’t have time to cover. 

The number next to each question indicates the approximate time the question was addressed in the webcast playback.

PPE/Supplies

Are we going to publish how many supplies/PPEs/tests we have? 32:52 
Part of the effort happening at a provincial level is counting and collating all supplies so eventually a briefing can be shared that includes modelling of demand and supply and specifics of the provincial picture. 
Can you clarify the PPE protocol for non-clinical staff working within the sites, ie. clerks etc? 47:00 

PPE guidance comes directly from the Province. There have been concerns about the interpretation of what a ‘clinical care area’ means and whether you are providing ‘direct care’ to patients. For now, if you are in a clinical area at the hospital that provides patient care you will follow the minimum basic PPE on that ward. In your work area you should be aware of what the minimum PPE equipment is, which generally is a surgical mask, some form of eye protection, and gloves.
For staff who work in areas that do not have direct interaction with patients (e.g. health records), personal protective equipment is not required.

If staff have direct contact with patients, they will following the guidance for “clinical care areas” and wear a surgical mask and eye protection.  If gloves are used, they must be worn in conjunction with hand hygiene (i.e. clean hands before donning gloves, after doffing gloves, and must be changed after each patient encounter.  Gloves should not be worn when a staff member is not providing direct patient care.
Will medical goggles be available for physicians? 50:02
Yes, goggles will be distributed to physicians, if needed. Distribution of goggles should be coordinated by physician leaders with Don Wills at dwills@providencehealth.bc.ca.

Testing

We will ensure health care workers, who need it appropriately, will get tested.  

In terms of capacity, all the labs across BC, St. Paul’s Lab in particular, have worked really hard to increase testing capacity. Comparing us internationally, we look good in terms of testing. But there is an understandable pressure to test more and now that we have the additional testing capacity I am sure that we will be doing this.

The public health team at the provincial level are working on the priorities for this increased capacity, which includes health care workers, vulnerable patients, vulnerable populations like the DTES, but also the rural populations who currently have had very little testing.

However, we also need to be careful about supplies. Currently, we have a good supply of swabs and reagents for testing, but the supply chain for those, along with everything else, is fragile. We need to ensure we don’t run out of these supplies. 

Are there any new tests in development that would detect positives in asymptomatic people? 56:00

At the start of the outbreak, there were concerns if asymptomatic transmission happened and how significantly. Now, there is increasing literature showing it does, but the literature is variable on how significant the transmission is and how much it’s contributing to the outbreak.  

We follow the Public Health guidelines for asymptomatic patients which currently say not to test. However, those guidelines may change, and if they do we will follow them.
Where can we find the screening questionnaires? 55:20
The screening questions/symptoms checklist is posted here on the COVID-19 website. These questions were updated on May 15, 2020. On Cerner, nursing staff use a checklist that reflects the same questions. The admitting teams should be aware of the screening questions and the pathway. 

Social Distancing

How are we implementing social distancing at all our sites? 48:37 

Wherever possible, we are using signage and removal of chairs to ensure appropriate physical distancing happens. Whenever it isn’t possible to ensure a two-metre distance is maintained, all parties wear procedure masks. We also promote Infection Prevention and Control measures, including frequent hand washing, not touching your face, wiping down hard surfaces frequently with a disinfectant wipe and staying home when sick. Of course, in clinical areas where direct patient care is happening and it isn’t possible to maintain a two-metre distance, appropriate PPE is being worn by all parties.

How many people are allowed in our elevators at one time? 43:09

The number of people allowed on an elevator at one time depends on if everyone is wearing a mask. If no one is wearing a mask, the norm is to have two people per elevator, however, if everyone is wearing a mask, more are allowed – it depends on the size of the elevator, what that number is – it could be two or it could be six. We do not want to see crowded elevators where everyone is touching shoulder to shoulder, so ask for some patience in that area. We also recommend that everyone wash their hands both before and after their elevator ride. We promote staff and patients using the stairs if the individual is physically capable of doing so.

Medical/virus transmission

Can you summarize the current data on infected health care workers at Providence? 42:00  

In terms of absolute numbers we can’t provide those numbers. For most of the health care workers at PHC who have been infected it has been related to community transmission. There are cases where we can’t tell, as there is no absolute community link. There are concerns some have been transmitted through work,  from health care worker to health care worker which has informed some of the changes we’ve had over the last few weeks in how we use PPE, and that’s been reflected in the provincial guidance.

Occupational Health & Safety

Is it ok for staff to be ordering food deliveries as a group to be eaten? Can food delivery people enter the hospital when there are visiting restrictions in place? 51:30  

We need to avoid, as much as possible, people coming on site. As of May 18, the protocol is any food delivery companies delivering food (i.e. Skip The Dishes, UBER eats, Pizza Delivery) MUST use the information desk or the phone to call the switchboard and communicate to the unit.  Someone from the unit must come to collect the delivery at the door. Please do NOT let them go any further into the building.  

Any food on units or food deliveries should be individually wrapped, and not shared (i.e not pizza).

Response Planning

What is PHC’s leadership and staff role in setting up the Convention Centre? 34:00  

Providence is assisting Vancouver Coastal Health, the Ministry of Health, Health Emergency Management BC, the Canadian Red Cross and B.C.'s Mobile Medical Unit to mobilize an alternate care site at the Vancouver Convention Centre as part of COVID-19 preparedness planning. This is a provincial resource, led by Vancouver Coastal Health, and its purpose as an alternate care site is to add more bed capacity for lower acuity, non-COVID-19 patients so additional capacity can be created within regional hospitals for critically ill COVID-19 patients who may need access to our critical care units. For more, click here.

What are the thoughts on data from Italy suggesting there may be a benefit to concentrate Covid patients at a single site? 44:15 

There are practical issues with doing this. We are practicing some aspects of those interventions in our transfers from MSJ to SPH for acute care. MSJ currently has capacity to manage patients who are COVID positive who don’t need critical care or higher levels of care. How that capacity will be able to increase will require a review of data based on how many patients are admitted in the coming weeks. 

Given the variety of symptoms covid patients present with it would be difficult for ambulance services to determine which site is most appropriate.

A big impact in Italy was moving covid positive patients from the acute hospital to a long term care facility. In a crisis situation that's usually what you do, but it had a massive impact on those long term care facilities. Given the time we’ve had to prepare, we’ve been able to put clear protocols in place regarding secondary transfers. That’s an important lesson we’ve learned from Italy.

During this period of low capacity as we prepare, we’re also looking at a strategy to designate admissions to certain wards. We’ve started with 7A/B as our covid-admission/under investigation ward, and are looking at our next unit for expansion. Staff and medical staff received an info bulletin about our ‘red- yellow-green’ communication strategy to convey the types of patients on our units. Red are units with known Covid patients, yellow with suspected patients under investigation, and green with no known covid patients. This helps team members be aware of what types of patients are on the units so they know what PPE may potentially be required. 

When will we see an increase in Covid patients? 49:36
That’s difficult to ascertain at this time. We hope we are flattening the curve. If we look at our critical care admissions, the data seems good. 

Patient Care/Treatment

How is PHC addressing the dual public health emergency simultaneously (COVID + Opioid) and how will we support individuals who use drugs across a variety of services? 57:21   

Our Addictions team, AMCT, has been very active and will continue to offer 24/7 help for patients with addictions.  There is a new provincial mandate to expand the replacement therapies and this will address a lot of the issues we have.  We still have to maintain our focus on overdose prevention, that’s really important. Our addictions team will continue to get people on appropriate replacement therapies.

We’re working with our community partners on a number of initiatives including housing and shelters for homeless people in Vancouver. There are two new teams being rolled out to support housing and shelter providers in the DTES and homeless patients in Vancouver. The COVID outreach team is offering support for urgent and emergent needs.

Is it possible to get iPads for patients so they can be in touch with their families? 52:18 
Watch for news coming on this. We’ve been looking at this idea with the Foundation, especially for long-term care. We still need to work out the logistics of how they will be stored and accessed. We appreciate hearing creative solutions that help patients and their families be supported.

 

This page last updated May 27, 2020 5:46pm PDT